Men'S Health Issues

Epidemiology

Health, United States, 2005 (National Center for Health Statistics) provides extensive data on trends and current information on selected determinants and measures of health status relevant to the health of men and differences between men and women. These data raise many questions and suggest areas for further study and interventions related to differences in health outcomes by gender, race, education, and other variables. The information in this report includes the following:

• Life Expectancy. In 2002, life expectancy for males (at birth) was 74.5 years, while for females, 79.9 years. Between 1990 and 2002, life expectancy at birth increased more for the Black population than for the White population, thereby narrowing the gap in life expectancy between these two racial groups. In 1990, life expectancy at birth was 7.0 years longer for the white than for the black population. By 2003, the difference had narrowed to 5.2 years. However, for black men, the difference was 6.3 years.
• Death Rates. For males and females, age-adjusted death rates for all causes of death are three to four times higher for those with 12 years or less education compared with those of educational attainment of 13 years or more. Males continued to have higher death rates due to diseases of the heart (286.6 vs. 190.3), malignant neoplasms (233.3 vs. 160.9), chronic liver disease and cirrhosis (12.9 vs. 6.3), HIV disease (7.1 vs. 2.4), motor vehicle injuries (21.6 vs. 9.3), suicide (18.0 vs. 4.2), and homicide (9.4 vs. 2.6). In 2002, adolescent boys (15 to 19 years) were five times as likely to die from suicide as adolescent girls, in part reflecting their choice of more lethal methods, such as firearms.
• Cancer Incidence. Incidence rates for all cancers combined declined in the 1990s for males. Cancer incidence was higher for black males than for males of other racial and ethnic groups. In 2001, ageadjusted cancer rates for black males exceeded those for white males by 50% for prostate, 49% for lung and bronchus, and 16% for colon and rectum.
• Tobacco Use. In 2003, 24% of men were smokers, compared with 19% of women. Cigarette smoking by adults is strongly associated with educational attainment. Adults with less than a high school education were three times more likely to smoke than were those with at least a bachelor's degree or more from college.
• Alcohol Use. Among current drinkers 18 years and older, 40% of men and 20% of women reported drinking five or more alcoholic drinks on at least one day (binge drinking) in the past year. Among males in Grades 11 and 12, 22.4% drove after drinking alcohol, compared with 12.3% of females.
• Seat Belt Use. In 2003, 22% of male high school students rarely or never used a seat belt compared with 15% of female high school students.
• Access to Health Care and Health Insurance. Working-age males 18 to 64 years were nearly twice as likely as working-age females to have no usual source of health care (22% vs. 12%). Men of all ages, particularly between the ages of 18 and 54, are less likely than women to visit physician offices and hospital outpatient and emergency departments. For all persons below 65 years of age, males are less likely to have health insurance than are females.

“Real” versus “Actual” Causes of Death

The mortality data presented above represent the reported causes of death on death certificates and indicates the primary pathophysiologic conditions identified at the time of death, as opposed to the root causes of the death. Major external (nongenetic) modifiable factors that contribute to death have been labeled “the actual causes of death.” Half of the deaths that occurred among U.S. residents in 1990 were potentially preventable and could be attributed to the following factors: tobacco use (19%), diet/activity patterns (14%), alcohol (5%), microbial agents (4%), toxic agents (3%), firearms (2%), sexual behavior (1%), motor vehicles (1%), and illicit use of drugs (< 1%). A similar analysis of the “actual causes of death” in 2000 showed that tobacco smoking remains the leading cause of mortality but diet and physical inactivity may soon overtake tobacco as the leading cause of death.

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